Hello everyone & Happy New Year!! I haven’t posted before, but I’m on here a lot reading posts to educate myself on treatments.
My Mom was diagnosed Feb 2023 de novo stage 4 breast cancer to bones only. She had 2 1/2 rounds of Ibrance from April 23- June 23 (stopped Ibrance in July 23 due to shortness of breath). Onc has kept her on Letrozol only now. Her lastest PET scan a few days ago shows all tumors are still getting smaller. There is no new progression. I don’t understand how the tumors can still shrink when she is not on Ibrance and only Letrozole. Does the Ibrance stay in the system and keeps working? Or can Letrozole alone shrink the tumors? We haven’t had her Onc appt yet to go over the scan. But I’m wondering if Letrozole alone can shrink away the tumors. I understood that the treatments would only hold back the progression. Well I guess I shouldn’t say shrink away, the tumors are still there.
Thanks in advance for any input. I appreciate this forum and all of you for sharing information!!!
Angela
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MBC2023
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Sorry to hear of your situation. Letrozole alone can work successfully to block the hormones that fuel the cancer if your cancer is estrogen based.
By effectively starving the cancer. I have heard of others here on this platform having years of successful treatments using Letrozole alone.
From what I understand Ibrance passes out of the system within 3-4 days maximum and that's why there's that week break in the cycle to allow blood cell counts to improve before the next cycle.
Discocat, thanks so much for your kindness in taking the time explaining. I now have a better understanding and can tell my Mom (because she asked me these questions yesterday and we I had no idea of the answers!!!).
I started on Letrazole in 2015. It didn’t do anything for me and I had 9 rounds of Abraxane and then started Exemestane and Afinitor. I stopped Afinitor after ten months due to side effects. I stayed on Exemestane and over the last 7 years my mets have continued to shrink. The breast tumour is no longer visible on scans. I had progression into abdominal nodes last March but a follow up scan 12 weeks later showed the nodes were half the size so I stayed on Exemestane. The December scan showed the nodes continue to shrink. There are women who are still on Letrazole after ten and even 13 years. I hope this is your mother’s experience too.
It wasn’t effective for me but a different hormone blocker has been. No one knows why and my doctor originally thought I might get two years on Exemestane alone. They’ve been pleasantly surprised by the results I have had and continue to have. I’m not NED but my scan reports are consistently described as stable and I’m happy with that. There’s lots more things to try now than there were in 2015 so even if the first medication is not as good for us as it could be, there’s still plenty of other things available and there’s more coming through trials.
Letrozol inhibits the hormones from feeding the cancer. Ibrance slows down all cell reproduction, healthy and cancer cells. If Letrozol is starving the cancer, it will shrink. Ibrance just makes the cancer progress slower.
I was diagnosed with Metastatic Breast Cancer 5 years ago. My initial treatment for two years was Ibrance and Letrozole and quarterly Bone Infusions with Zometa. My side effects from Ibrance, even with progressive reductions, led me to decide to quit Ibrance. My Oncologicst agreed and said she had many patients being treated only with Letrozole. This past Fall I was told that my MBC was in Remission. How long that will last I do not know but I believe, as does my Oncologist, that Letrozole continues to work well for me. I do not know how long Ibrance remains in one's system but given that my side effects from that drug went away as soon as I quit using Ibrance, I assume it does NOT linger.
YOU and your Mother are going through a difficult time and I hope there are counseling services available for each of you, as have been for me and my husband. Most importantly, KEEP ASKING QUESTIONS of your Doctor(s) as well as reaching out on this valuable resource.
Trusig- thank you for sharing this! I am happy Letrozole alone has worked so well for you!!! It’s so good to hear this! 😊 You are very similar to my Mom in that she had to stop Ibrance due to side effects and on Letrozole only. I hope you stay in remission forever!! So glad it’s worked so well for you. Thanks again for responding & enjoy your weekend.
Thank you Kerry & Cyndi for your responses. I have a much better understanding of Leetrozole’s role in her treatment now. I panicked when her Onc stopped the Ibrance and kept her on Letrozole only….but it’s been about 7 months and the tumors are continuing to shrink. It makes me feel calmer hearing and knowing there are many other options if things should change. Thank you all for kindly sharing your experiences!!!!!
Exactly, the aromotase inhibitors (letrozole, anastrozole and exemestane) are the heavy hitters, "starving" the cancer of estrogen. (The SERDs also block estrogen, like fulvestrant). The CDK4/6 inhibitors (Ibrance, Kisqali and Verzenio) are "targeted" treatments and can make the estrogen blockers more effective, but also have more risks of serious side effects. They are relatively new. People with mbc used to be treated with only the AIs.
I am on both letrozole and ibrance but before ibrance, I was on letro with kisqali.
Due to side effects, I was taken off kisqali and it took 5 months for my counts to get back into range before I could be put on ibrance.
I was quite worried about not being on the CDK inhibitor during that time but my oncologist explained that letro is the workhorse of the two meds, and that many people are on letro alone, with great success.
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Slight increase in tumor marker
Question about imaging and biopsies 
Question about CT scan
Liver tumors progressed 
Tumors Shrinking! 
